Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 0401004205 | VA |
NPI | 1306800776 |
---|---|
Provider Name | Dr. James C Burns |
First Address | Richmond, VA 23298-0566 |
Second Address | Richmond, VA 23219-1610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 15/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
179780 | ANTHEM ID # (01) | VA |
P00380317 | RAILROAD MEDICARE (01) | |
T90538 | (02) | VA |